Geographic distribution and time trends of esophageal cancer in Brazil from 2005 to 2015

Abstract

The purpose of the present study was to investigate the geographical distribution and time trends of the incidence and lethality of esophageal cancer (EC) in Brazil. The present study conducted an ecological study of EC using records from January 2005 to December 2015 in the Health Informatics Department of the Brazilian Ministry of Health (DATASUS) registry. In addition to demographical data on the population, EC incidence and lethality rates were estimated from hospitalizations and in-hospital mortalities and were adjusted by total available hospital beds. The adjusted EC rates per 100,000 increased from 9.1 in 2005 to 12.1 in 2015. The prevalence among males increased from 69 to 78%, while the female rates remained stable over the same period. Although EC was the most common in South and Southeast Brazil, the rates increased proportionately more in the other regions of the country, especially among males. Geographical analysis revealed higher rates of EC in more urbanized areas, with a coast-to-inland gradient. While rates increased in people older than 50 years, they decreased among people below this age. However, the lethality rates remained stable and high during the study period, overlapping with hospital admission rates. The recent increasing trend in the EC incidence, with shifts from the south towards the north and from more urbanized towards rural areas, suggests that environmental factors are crucial in EC pathogenesis. The concentration of EC in South Brazil may reflect the presence of major environmental factors in association with a possible genetic predisposition. The unchanging high mortality associated with EC in the rapidly aging population suggests that EC will continue to impose a significant social and economic burden in the future.

Esophageal Cancer Mortality in Brazil: A Time-Series Analysis From the Global Burden of Disease Study

“…The more developed regions are also those that have better access to quality health services to diagnose and provide the proper treatment to the disease. Additionally, the growing mortality rates in the less developed states agree with studies that show a higher incidence of esophageal cancer in urban and developed areas of the country (15) .…”

“…In Brazil, a study evaluated the mortality of cancer from 1990 until 2015 and estimated a significant reduction of approximately 14% in mortality by esophageal cancer with similar patterns among the states, except for Ceará and Paraíba, both in the Northeast region, which had a significant increase in the last decades (5) . On the other hand, another study evaluated the temporal trends of esophageal cancer and reported an increase of incidence between 2005 and 2015, while the death rate remained the same (15) .…”

Mapping the Trends in Esophageal Cancer Disease Burden in the United States: Results from the Global Burden of Disease Study 2017

“…Economic factors play an essential role in the incidence rate and mortality rate of EC. Low socioeconomic status is associated with the higher EC incidence, which results from the combined in uence of increased alcohol use and smoking, lower annual income, lower annual expenditure on food, lower yearly expenditure on fruit and vegetables, higher unemployment rate, and higher employment rate in agriculture and construction sectors [24][25][26]. Additionally, low socioeconomic status is associated with a dismal prognosis, resulting from inadequate awareness of the malignant disease, reduced access to health services, and less performed resection and chemotherapy [27][28][29].…”

Hospitalization and surgery rates in patients with inflammatory bowel disease in Brazil: a time-trend analysis

“…Data available from the Health Informatics Department/Brazilian Ministry of Health (DATASUS) ( http://www2.datasus.gov.br/DATASUS ) were retrospectively retrieved, similar to previous studies from our group addressing gastrointestinal malignancies [ 28 – 30 ]. In the DATASUS homepage, health information is available through the tabulation software TABNET, with access to Epidemiology and Morbidity data ( http://www2.datasus.gov.br/DATASUS/index.php?area=0203&id=6926 ).…”

“…gov. br/ DATAS US) were retrospectively retrieved, similar to previous studies from our group addressing gastrointestinal malignancies [28][29][30]. In the DATASUS homepage, health information is available through the tabulation software TABNET, with access to Epidemiology and Morbidity data (http:// www2.…”